Objective: Hyperprolactinemia is a common and chronic disorder with metabolic and psychological consequences. The aim of this study is to evaluate depression levels and health status and its relationship with insulin resistance in hyperprolactinemic premenapousal women. Design and patients: Nineteen hyperprolactinemic premenopausal women were enrolled in the study. All patients have a pituitary microadenoma. Twenty healthy women subjects matched in age were included as controls. All hyperprolactinemic patients were evaluated twice, before the study and after the suppression of prolactin levels. Patients were given bromocriptine (2,5- 20 mg /dL) and the dosage was titrated monthly until prolactin levels were lowered below 20 ng/dl All subjects evaluated for SF-36 Quality of Life Questionnaire, Symptom Check List-90-R (SCL-90-R), Beck Depression Inventory (BDI) and an oral glucose tolerance test was performed to evaluate insulin sensitivity before and after treatment. Results: Beck Depression inventory score was significantly higher in non-treated hyperprolactinemic patients compared with post-treatment levels (p<0.05) and healthy controls (p<0.001). In analysis of SCL-90 scales, hyperprolactinaemic patients were more depressive (p<0.001) hostile (p<0.05), anxious (p<0.05) and phobic (p<0.05) than the control subjects. Anxiety scale scores decreased after bromocriptine treatment (p<0.05). Insulin sensitivity index was significantly lower in non-treated hyperprolactinemic group compared with post-treatment calculations (p<0.05) and healthy controls (p<0.01) Conclusions: hyperprolactinemia is associated with depression, anxiety, phobia and hostility in women with prolactinomas. Bromocriptine treatment had beneficial effects on depression and anxiety. Increased insulin resistance, decreased estrogen or increased prolactine may take part in the mechanism of depression in hyperprolactinemic premenopausal women.Keywords: Prolactin insulin resistance depression bromocriptine quality of life

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Summary

Objective: Hyperprolactinemia is a common and chronic disorder with metabolic and psychological consequences. The aim of this study is to evaluate depression levels and health status and its relationship with insulin resistance in hyperprolactinemic premenapousal women. Design and patients: Nineteen hyperprolactinemic premenopausal women were enrolled in the study. All patients have a pituitary microadenoma. Twenty healthy women subjects matched in age were included as controls. All hyperprolactinemic patients were evaluated twice, before the study and after the suppression of prolactin levels. Patients were given bromocriptine (2,5- 20 mg /dL) and the dosage was titrated monthly until prolactin levels were lowered below 20 ng/dl All subjects evaluated for SF-36 Quality of Life Questionnaire, Symptom Check List-90-R (SCL-90-R), Beck Depression Inventory (BDI) and an oral glucose tolerance test was performed to evaluate insulin sensitivity before and after treatment. Results: Beck Depression inventory score was significantly higher in non-treated hyperprolactinemic patients compared with post-treatment levels (p<0.05) and healthy controls (p<0.001). In analysis of SCL-90 scales, hyperprolactinaemic patients were more depressive (p<0.001) hostile (p<0.05), anxious (p<0.05) and phobic (p<0.05) than the control subjects. Anxiety scale scores decreased after bromocriptine treatment (p<0.05). Insulin sensitivity index was significantly lower in non-treated hyperprolactinemic group compared with post-treatment calculations (p<0.05) and healthy controls (p<0.01) Conclusions: hyperprolactinemia is associated with depression, anxiety, phobia and hostility in women with prolactinomas. Bromocriptine treatment had beneficial effects on depression and anxiety. Increased insulin resistance, decreased estrogen or increased prolactine may take part in the mechanism of depression in hyperprolactinemic premenopausal women.Keywords: Prolactin insulin resistance depression bromocriptine quality of life